Sarah Walmsley1, Peter G Osmotherly2, Darren A Rivett3. 1. School of Health Sciences, Faculty of Health, The University of Newcastle, University Drive, Callaghan, NSW, 2308 Newcastle, Australia. Electronic address: Sarah.Walmsley@uon.edu.au. 2. School of Health Sciences, Faculty of Health, The University of Newcastle, University Drive, Callaghan, NSW, 2308 Newcastle, Australia. Electronic address: Peter.Osmotherly@newcastle.edu.au. 3. School of Health Sciences, Faculty of Health, The University of Newcastle, University Drive, Callaghan, NSW, 2308 Newcastle, Australia. Electronic address: Darren.Rivett@newcastle.edu.au.
Abstract
OBJECTIVES: To evaluate patients clinically diagnosed with early stage primary/idiopathic adhesive capsulitis to determine the existence of any pattern of movement loss and associated pain that may facilitate early recognition. DESIGN: Cross-sectional study. SETTING: Private upper limb specialty clinic, Newcastle, Australia. PARTICIPANTS: Fifty-two patients clinically diagnosed with early stage adhesive capsulitis by a medical practitioner or physiotherapist. MAIN OUTCOME MEASURES: Percentage loss of active and passive ranges of eight shoulder movements and the pain level at the end of each movement. The reason for limitation of movement was also recorded. RESULTS: Factor analysis clearly identified two groups for percentage loss of active range of movement. Notably external rotation movements grouped separately from other movements. A single group emerged for percentage loss of passive range of movement suggesting a non-specific global loss. For both pain at the end of active range of movement and passive range of movement two groups emerged, however the delineation between the groups was less clear than for percentage loss of active range of movement suggesting a pattern of end range pain may be less useful in identifying patients in this stage. CONCLUSIONS: External rotation movements in neutral and abduction generally group together and behave differently to other shoulder movements in patients clinically diagnosed with early stage primary/idiopathic adhesive capsulitis. In particular external rotation in abduction has emerged as the most painfully limited movement in this sample. This study provides preliminary evidence of patterns of range of movement and end range pain that require testing in a population of mixed shoulder diagnoses to determine their diagnostic utility for early stage adhesive capsulitis.
OBJECTIVES: To evaluate patients clinically diagnosed with early stage primary/idiopathic adhesive capsulitis to determine the existence of any pattern of movement loss and associated pain that may facilitate early recognition. DESIGN: Cross-sectional study. SETTING: Private upper limb specialty clinic, Newcastle, Australia. PARTICIPANTS: Fifty-two patients clinically diagnosed with early stage adhesive capsulitis by a medical practitioner or physiotherapist. MAIN OUTCOME MEASURES: Percentage loss of active and passive ranges of eight shoulder movements and the pain level at the end of each movement. The reason for limitation of movement was also recorded. RESULTS: Factor analysis clearly identified two groups for percentage loss of active range of movement. Notably external rotation movements grouped separately from other movements. A single group emerged for percentage loss of passive range of movement suggesting a non-specific global loss. For both pain at the end of active range of movement and passive range of movement two groups emerged, however the delineation between the groups was less clear than for percentage loss of active range of movement suggesting a pattern of end range pain may be less useful in identifying patients in this stage. CONCLUSIONS:External rotation movements in neutral and abduction generally group together and behave differently to other shoulder movements in patients clinically diagnosed with early stage primary/idiopathic adhesive capsulitis. In particular external rotation in abduction has emerged as the most painfully limited movement in this sample. This study provides preliminary evidence of patterns of range of movement and end range pain that require testing in a population of mixed shoulder diagnoses to determine their diagnostic utility for early stage adhesive capsulitis.
Authors: Stephen Brealey; Matthew Northgraves; Lucksy Kottam; Ada Keding; Belen Corbacho; Lorna Goodchild; Cynthia Srikesavan; Saleema Rex; Charalambos P Charalambous; Nigel Hanchard; Alison Armstrong; Andrew Brooksbank; Andrew Carr; Cushla Cooper; Joseph Dias; Iona Donnelly; Catherine Hewitt; Sarah E Lamb; Catriona McDaid; Gerry Richardson; Sara Rodgers; Emma Sharp; Sally Spencer; David Torgerson; Francine Toye; Amar Rangan Journal: Health Technol Assess Date: 2020-12 Impact factor: 4.014